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Big Bowel Blues

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Name: Perth Guy
Gender:
Age: 50
Location: Perth Australia
Hey Dr Dick,
I am going to have surgery to fix Diverticular Disease by removal of the sigmoid colon, which may result in a temp or perm stoma (Colostomy). If it’s a permanent colostomy bag I know they basically remove your rectum, so no more anal sex. If it’s a temp stoma/colostomy bag can you still have anal sex? (whilst you rectum is “disconnected from the colon) If they are able to reverse it later and connect the transverse colon to the rectum is it still possible to have anal sex? I don’t know who to ask this very strange question – its not a question you can ask around ” do you have a colostomy – do you have anal sex?”

Hey thanks for your message, Perth Guy. Sorry to hear you’re feeling poorly. For those of us unfamiliar with diverticular (say: die-ver-tick-yoo-ler) disease, it affects the large intestine, or colon. It’s caused by small pouches that form, usually on the wall of the last part of the large intestine — the sigmoid colon. These pouches are called diverticula, don’t ‘cha know.

The terms ostomy and stoma are general descriptive terms that are often used interchangeably though they have different meanings. An ostomy refers to the surgically created opening in the body for the discharge of body wastes. A stoma is the actual end of the small or large bowel that is arranged to protrude through the abdominal wall.

I know it’s difficult to find helpful information about sexual concerns, like butt fucking, when facing a radical and disfiguring medical procedure like a colostomy. Our culture has such difficulty talking about sex even as it applies to healthy folks, it’s no wonder we fail those of us who are sick, maimed, or disabled. I did, however, find a resource for you, Colostomy Pen Pals. http://www.ostomy.evansville.net/ocncolostomy.htm

I suspect that you’ll not readily find the specific information about anal sex that you are looking for on that site. But here’s where you can do yourself and all your fellow ostomy patients a good turn. I want you to march right over to Colostomy Pen Pals and any other ostomy resource you might find online and just come out with it. Just like you did when you wrote to me. You know that if you have a concern about anal sex post surgery, there are a shit-load of others (you should pardon my pun) out there who share your concern and interest and may have first-hand information to share.

Probably, there a lot of other folks who are too timid to ask or share about this concern. So instead of stewing in your isolation and lack of information, why not take the initiative and break open the topic yourself. If you’re gonna wait around for someone else to broach the issue, when you won’t, you’re gonna die waiting, my friend.

And if you think the information you are looking for will come from the medical industry, you really have to wake up and smell the coffee, my friend. The best resource you’re gonna find is gonna be others in the ostomy community. Those folks, who are similarly challenged as you, will be the front line of the information you seek. But like I said, if you fail to put out there what you want, you can be sure no one is gonna spoon feed it to you.

So while it is true what you say: “its not a question you can ask around to the general public do you have a colostomy – do you have anal sex?” It is a very appropriate question to be asking the ostomy community. And if you find resistance in that community for bringing this pressing sexual concern there, stand your ground, darlin’!

And just so you don’t think I’m ducking the question, my experience with ostomy patients suggest that it may very well be more of a question of wanting to have anal sex post surgery, than the ability to do so. I guess you’re just gonna have to wait and see for yourself. Keep me posted and I’ll keep our audience posted on this too.

Good luck

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Sex Education Based on Abstinence? There’s a Real Absence of Evidence

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Sex education has long occupied an ideological fault line in American life. Religious conservatives worry that teaching teenagers about birth control will encourage premarital sex. Liberals argue that failing to teach about it ensures more unwanted pregnancies and sexually transmitted diseases. So it was a welcome development when, a few years ago, Congress began to shift funding for sex education to focus on evidence-based outcomes, letting effectiveness determine which programs would get money.

But a recent move by the Trump administration seems set to undo this progress.

Federal support for abstinence-until-marriage programs had increased sharply under the administration of George W. Bush, and focus on it continued at a state and local level after he left office. From 2000 until 2014, the percentage of schools that required education in human sexuality fell to 48 percent from 67 percent. By 2014, half of middle schools and more than three-quarters of high schools were focusing on abstinence. Only a quarter of middle schools and three-fifths of high schools taught about birth control. In 1995, 81 percent of boys and 87 percent of girls reported learning of birth control in school.

Sex education focused on an abstinence-only approach fails in a number of ways.

First, it’s increasingly impractical. Trying to persuade people to remain abstinent until they are married is only getting harder because of social trends. The median age of Americans when they first have sex in the United States is now just under 18 years for women and just over 18 years for men. The median age of first marriage is much higher, at 26.5 years for women and 29.8 for men. This gap has increased significantly over time, and with it the prevalence of premarital sex.

Second, the evidence isn’t there that abstinence-only education affects outcomes. In 2007, a number of studies reviewed the efficacy of sexual education. The first was a systematic review conducted by the National Campaign to Prevent Teen and Unplanned Pregnancy. It found no good evidence to support the idea that such programs delayed the age of first sexual intercourse or reduced the number of partners an adolescent might have.

The second was a Cochrane meta-analysis that looked at studies of 13 abstinence-only programs together and found that they showed no effect on these factors, or on the use of protection like condoms. A third was published by Mathematica, a nonpartisan research organization, and it, too, found that abstinence programs had no effect on sexual abstinence for youth.

In 2010, Congress created the Teen Pregnancy Prevention Program, with a mandate to fund age-appropriate and evidence-based programs. Communities could apply for funding to put in only approved evidence-based teen pregnancy prevention programs, or evaluate promising and innovative new approaches. The government chose Mathematica to determine independently which programs were evidence-based, and the list is updated with new and evolving data.

Of the many programs some groups promote as being abstinence-based, Mathematica has confirmed four as having evidence of being successful. Healthy Futures and Positive Potential had one study each showing mixed results in reducing sexual activity. Heritage Keepers and Promoting Health Among Teens (PHAT) had one study each showing positive results in reducing sexual activity.

But it’s important to note that there’s no evidence to support that these abstinence-based programs influence other important metrics: the number of sexual partners an adolescent might have, the use of contraceptives, the chance of contracting a sexually transmitted infection or even becoming pregnant. There are many more comprehensive programs (beyond the abstinence-only approach) on the Teen Pregnancy Prevention Program’s list that have been shown to affect these other aspects of sexual health.

Since the program began, the teenage birthrate has dropped more than 40 percent. It’s at a record low in the United States, and it has declined faster since then than in any other comparable period. Many believe that increased use of effective contraception is the primary reason for this decline; contraception, of course, is not part of abstinence-only education.

There have been further reviews since 2007. In 2012, the Centers for Disease Control and Prevention conducted two meta-analyses: one on 23 abstinence programs and the other on 66 comprehensive sexual education programs. The comprehensive programs reduced sexual activity, the number of sex partners, the frequency of unprotected sexual activity, and sexually transmitted infections. They also increased the use of protection (condoms and/or hormonal contraception). The review of abstinence programs showed a reduction only in sexual activity, but the findings were inconsistent and that significance disappeared when you looked at the stronger study designs (randomized controlled trials).

This year, researchers published a systematic review of systematic reviews (there have been so many), summarizing 224 randomized controlled trials. They found that comprehensive sex education improved knowledge, attitudes, behaviors and outcomes. Abstinence-only programs did not.

Considering all this accumulating evidence, it was an unexpected setback when the Trump administration recently canceled funding for 81 projects that are part of the Teen Pregnancy Prevention Program, saying grants would end in June 2018, two years early — a decision made without consulting Congress.

Those 81 projects showed promise and could provide us with more data. It’s likely that all the work spent investigating what is effective and what isn’t will be lost. The money already invested would be wasted as well.

The move is bad news in other ways, too. The program represented a shift in thinking by the federal government, away from an ideological approach and toward an evidence-based one but allowing for a variety of methods — even abstinence-only — to coexist.

The Society of Adolescent Health and Medicine has just released an updated evidence report and position paper on this topic. It argues that many universally accepted documents, as well as international human rights treaties, “provide that all people have the right to ‘seek, receive and impart information and ideas of all kinds,’ including information about their health.” The society argues that access to sexual health information “is a basic human right and is essential to realizing the human right to the highest attainable standard of health.” It says that abstinence-only-until-marriage education is unethical.

Instead of debating over the curriculum of sexual education, we should be looking at the outcomes. What’s important are further decreases in teenage pregnancy and in sexually transmitted infections. We’d also like to see adolescents making more responsible decisions about their sexual health and their sexual behavior.

Abstinence as a goal is more important than abstinence as a teaching point. By the metrics listed above, comprehensive sexual health programs are more effective.

Whether for ethical reasons, for evidence-based reasons or for practical ones, continuing to demand that adolescents be taught solely abstinence-until-marriage seems like an ideologically driven mission that will fail to accomplish its goals.

Complete Article HERE!

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In college, sexual empowerment is more important than ever

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Hook-up culture shouldn’t be ignored; it should be empowered.

By Kelsey Thompson

Of the many anxieties incoming college students face, like heart attack-inducing syllabi or annoying roommates, one is particularly dreadful: hook-up culture.

The transition from high school to college is marked by increased independence and exposure to new people and experiences. So things get especially complicated when relationships and sex come into play. While that’s not to say that everyone attending college is interested or engaging in uncommitted sex, the amount of sex college students are having does create an environment where sexual education is not only advisable, but imperative.

From freshmen orientation onward, Syracuse University promotes conversations that extend beyond the cringe-inducing PowerPoints of middle school sex ed classes. With mandatory events like Speak About It, a monologue-based performance that highlights both the positives and negatives of sex, students are encouraged to take accountability for their sex lives without being condemned for it.

Michelle Goode, a health promotion specialist at the university’s Office of Health Promotion, said having positive conversations about sex makes students more likely to practice safely, protecting both themselves and their partners.

“Having more conversations about healthy sexuality and sharing accurate information and resources can be empowering, enhance intimate experiences and relationships, and help counter negative perceptions that perpetuate rape culture and gender-based oppression,” she said.

It’s especially important for women entering college to know their rights and find a sense of empowerment in their sex lives. In a male-dominated culture that simultaneously sexualizes women and condemns them for having sex, education is power. But it’s the university’s responsibility to provide the right tools for effective education.

Beyond university-run performances and events, SU Health Services is an essential tool for new students to utilize when it comes to sexual safety and prevention. Reproductive health counseling, STI screenings, birth control refills and condoms and emergency contraceptives are available for students on a regular basis.

“Programs and services that focus on sexual safety and education not only help students learn about the resources available, but also promote sex-positive messaging, which challenges the negative messaging students may encounter in the media and in pop culture,” Goode said.

But let’s face it — school-based sex education still has a bad rep. While SU provides basic resources and programs on sexual safety, clubs like SASSE take it to the next level.

SASSE, or Students Advocating Sexual Safety and Empowerment, promotes empowerment events, such as performances of “The Vagina Monologues” and condom giveaways, to help erase sexual taboos on campus. Taking advantage of these events can help students understand the reality of sexual empowerment in ways university offices simply can’t.

While college isn’t a constant cycle of frat parties and hook-up buddies, casual sex isn’t something to be afraid of or feel ashamed about. Sex is a natural thing to desire and engage in, and your body count is by no means reflective of your character or worth.

By having frank, open conversations about sexual safety, freshmen can breathe a sigh of relief. Know that while your 15-week class syllabi may be fear-inducing, sex should be anything but.

Complete Article HERE!

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4 things we really need to stop saying (and believing) about depression and sex

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It’s time to change your mind

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I always say that sex and depression is the intersection of two taboo topics.

It’s especially hard to talk about the two together because, frankly, it can be hard to talk about either topic separately.

Today, we’re going to look at some commonly held (and oft-repeated) beliefs that really need to be retired in the name of destroying the stigma around these important topics.

Also, they are just not true.

Depression is hard enough to cope with on its own. Don’t make it worse by piling on unfair, untrue cliches. Know the truth about sex and depression and help end the stigma.

Depressed people don’t want to have sex anyway

In 2014, I launched a survey on the impact of depression and its treatment on sexual function and relationships.

A total of 1,100 people took that survey.

In 2015, I started interviewing participants and only then did I spot the massive flaw in my survey: it only allowed for people to give responses about decreased libido.

When I conducted a second round of interviews in 2016 I asked, ‘Did depression impact your sex life? If so, how?’ and more than 29% of the respondents reported increased sexual activity during depressive episodes.

Don’t stick it in the crazy

Stop with this. It’s ableist and frankly it’s ridiculous.

Depression is not an STI and we don’t need to quarantine all the people with depression so they don’t sexually infect you.

Certainly you get to choose who you do and do not engage in sexual activity with, but reciting a (not at all clever) catchphrase, that is based in nothing, about dismissing an entire group of people just helps further stigma and makes people feel like they need to hide their own mental illness struggles.

Sex isn’t important enough to worry about when you’re fighting depression

A scenario that came up over and over in my research was patients being dismissed by doctors or the other people in their lives when they objected to sexual side effects because sex isn’t important enough to worry about ‘at a time like this’.

In some cases, the respondents believed it – ‘I didn’t worry about sex because there were more important things to worry about!’

Listen, yes, sometimes depression treatment is a fight to stay alive and we do whatever it takes, other times, it’s about maintenance and we are allowed to want more than just survival.

People with depression are allowed to want to actually live, and for a lot of people that includes sex.

You have to love yourself first before you can love anyone else

A lot of people will never love themselves.

When we tell people they are ineligible for love until they have hit this self-love goal (I know no one who has done this), what we are really doing is telling them that they have to be a better person in order to be loved.

Another variation on this is, ‘you have to get yourself together first’.

These are all nonsense, and the domain of people who want others to believe that relationships shouldn’t involve any baggage.

Everyone’s got baggage. You don’t need to pretend yours isn’t there to be loveable.

Complete Article HERE!

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All the reasons to masturbate — that have nothing to do with sex

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By WHIMN

Masturbation has so many health benefits, it should come with a certified AMA tick of approval. It increases blood flow, flushes your body with lovely endorphins, alleviates stress, boosts your self-confidence and keeps you in tune with your body and your sexuality. In short, it makes you feel great, and here at whimn, we’re all about that.

Real talk: Any time of day is a good time to masturbate. But some times are, well, more good than others.

Right before you go to work

Everyone has their morning checklist. Ours goes something like this. Shower, breakfast, coffee, brush teeth, rush out the door like a whirling devil to make the next bus to the office. But if you set aside a little more time in the morning, you could add an extra item to your to-do list: yourself.

Sure, masturbating in the morning won’t have the same languid sense of ease as a Sunday afternoon session, but it has plenty of health benefits that could improve your performance at work. You’ll be less stressed by office politics, will have more energy to tackle a big day at the desk and you’ll cut your beauty routine in half, courtesy of your natural, post-orgasm flush.

When you’re lacking in focus

If you feel yourself losing your concentration, it might be time to masturbate. Speaking to Bustle, Kit Maloney, the founder of O’actually, a feminist porn production company, said that “masturbation [and] orgasm is like meditation. It allows the space for the brain to quiet and that means you’ll be more focused and effective with your to-do list afterwards.”

When your mood is low

Think about a time of day when your energy levels and mood are running near-empty. It could be because you’re hung over, or because you’ve hit the mid-afternoon slump, or for a myriad of other reasons pertaining to you.

Whenever you feel your mood slipping is a great time to masturbate, thanks to all the nice dopamine that is released when you have an orgasm. Dopamine is a chemical that leads your body to feel pleasure, satisfaction and happiness, all things that help elevate your mood.

When you have your period

Though there’s been no specific scientific examination of this, in theory masturbation is a fantastic way to soothe menstrual cramps. That’s because when you have an orgasm, your uterine muscles contract and release naturally analgesic chemicals. Period pain, begone!

Before you go to sleep

There is a school of thought that says that since orgasms leave you in a state of heightened, pillowy relaxation bordering on bone-tiredness, you shouldn’t have one before anything that requires your brain to do heavy lifting.

Which means that one of the best times to have an orgasm is in bed, right before you go to sleep. There have been no studies explicitly examining the correlation between sleepiness and orgasms, but research by Kinsey found that participants noted that nightly masturbation helped them fall asleep, quickly and more smoothly. That might be because during climax, your body releases our old friend dopamine and then oxytocin, a nice little hormone cocktail that makes you feel very happy and then very tired all at once. Have an orgasm before bedtime and you might have the best sleep of your life.

Complete Article HERE!

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